Abstract

Point-scanning reflectance confocal microscopes continue to be successfully translated for detection of skin cancer. Line-scanning, with the use of a single scanner and a linear-array detector, offers a potentially smaller, simpler and lower cost alternative approach, to accelerate widespread dissemination into the clinic. However, translation will require an understanding of imaging performance deep within scattering and aberrating human tissues. We report the results of an investigation of the performance of a full-pupil line-scanning reflectance confocal microscope in human skin and oral mucosa, in terms of resolution, optical sectioning, contrast, signal-to-noise ratio, imaging and the effect of speckle noise.

Highlights

  • Confocal point-scanning microscopes are being translated for clinical applications in dermatology and are showing promise for in vivo diagnosis of melanoma and basal cell carcinoma [1], pre-operative mapping of amelanotic and lentigo maligna melanomas to guide surgery [2] mosaicing of basal cell carcinomas in excised tissue from Mohs surgery [3,4] and detection of residual nonmelanoma skin cancer in shave biopsy wounds [5]

  • In our line-scanner design, because there is no infinity space that is common to both the illumination and detection paths, the quarter-wave plate (QWP) must be placed in the converging illumination beam

  • The full-pupil line-scanning confocal microscope demonstrates optical sectioning that compares to the expected axial response function calculations, and measurements through human epidermis shows degradation of sectioning by about a factor of two

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Summary

Introduction

Confocal point-scanning microscopes are being translated for clinical applications in dermatology and are showing promise for in vivo diagnosis of melanoma and basal cell carcinoma [1], pre-operative mapping of amelanotic and lentigo maligna melanomas to guide surgery [2] mosaicing of basal cell carcinomas in excised tissue from Mohs surgery [3,4] and detection of residual nonmelanoma skin cancer in shave biopsy wounds [5]. Of interest to us for cancer screening and diagnostic applications is imaging performance deep within the highly scattering and aberrating conditions of human tissues such as skin and oral mucosa. Studies of imaging performance are the necessary translational bridge from technology development to clinical implementation. To investigate performance under expected clinical conditions, the strongly scattering and aberrating conditions in human epidermis offers a realistic testing ground for both our immediate interest in skin cancer and for future application in other epithelial tissues. The divided-pupil configuration demonstrated sharp optical sectioning, resolution and contrast for imaging nuclear and cellular detail in the epidermis of human skin and epithelium of oral mucosal in vivo [18]. We report the results of an investigation of the performance of a full-pupil line-scanning reflectance confocal microscope in human epidermis. The goal is to develop a clear understanding of line-scanning performance for potential translation to clinical applications

Optical design
Electronics design
Axial response measurements
Noise characterization of the linear array detector
Imaging methods
Investigation of speckle noise
Imaging of human epidermis in vivo
Conclusions and Discussion

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